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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-2.1 <br />MBEIWBE CONTACTED <br />This completed form should be supplied with Bids that pertain to Cliy of South Bend Public Works Projects <br />requiring contacted MBE/WBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify <br />whether any listed minority or woman business meets the qualifications of a Minority or Women's owned <br />business. <br />�PACE---L—OF. <br />Project Number; <br />116-027 <br />A 1 ;F-rIM03111150 MIC me, I <br />Project Name: Jefferson and Twy"k vements <br />Bidder: MartdII Electric. LLC <br />0 <br />President <br />(Date) <br />MBE/WBE Firm Premium Concrete Servic)s, Inc <br />Owner or Contact at MBEANBE Firm Rota Becker <br />Telephone: (574) 264-0196 Fax,. Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Received commitment from Premium Concrete Services, Inc that they will participate if we are awarded <br />RESULTS OF CONTACT WITH THE MOE/WBE FIRM: <br />MBENVBE Firm <br />Owner or Contact at MBENVBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM' <br />Version 10/17/2017' Contractors Bid for Public Works - 11 Addendum #1 <br />